HomeMy WebLinkAboutX2021-1352 - Permit Application (2)F.Comm'I F_ Residential
City of Newport Beach Building Division n
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 2 it -13 ��aa�•'
r- Building r Grading
(-Drainage 'Elec rMech r Plum euydCutr�• Cu yd Fill
Project Address (Not mailing address) F_ Flood j'- Fire j® Liq r Landslide F_N/A Floor Suite No
iAjSQ���-4%t. �SVUf
I l
Description of Work
�
Use F_ Const Type I—
�i (,i•V G1 °l �. %"lnlfdzi
- OyAl hoof?Cs
6'Vakl_ bea-lel
#Stories #Units (if Res)
New/Add SFF------
Remodel SF Rj�i
Garage/New/Add F-----
Valuation $
Material/Labor (J OCL,
OWNER'S NAME
Last�
�iJiVC l)�G' j'�
Fit flrs
�lCt fP
Owner's. Address
Owner's E-mail Address
h
City
Statee�— / .Zip F — .Telephone—
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State F_
Zip F Telephoner---
ARCHITECT/DESIGNER'S NAME Last First - — ` Lic. No. r—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State I
Zip �--�.— .Telephoner-.�-.------ -
ENGINEER'S NAME
Last �--.-.--_
First r----�-i Lic No.r--
Engineer's Address
Engineer's E-mail Address
City
State r-
Zip Telephonel
CONTRACTOR'S NAME/COMPANY
LicNo. FloW-12 0 Classr�
Contractor's Address
Contractor's E-mail Address
City _
_ State
Zip r----'--- Telephone�jk 6j J
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $